Herrero Egea Ana, Pérez Delgado Laura, Tejero-Garcés Galve Gloria, Guallar Larpa María, Orte Aldea Carmen, Ortiz García Alberto
Servicio de Otorrinolaringología, Hospital Universitario Miguel Servet, Zaragoza, España.
Acta Otorrinolaringol Esp. 2013 Jan-Feb;64(1):1-5. doi: 10.1016/j.otorri.2012.06.002. Epub 2012 Dec 20.
Zenker's diverticulum has been approached surgically with different techniques over the years, evolving from open to endoscopic surgery. The CO(2) laser or the stapler can be used in endoscopic surgery. Our objective was to ascertain the recurrence or persistence of the diverticulum based on the type of surgery performed.
A retrospective descriptive study of 22 patients treated for Zenker's diverticulum in our hospital service between 2001 and 2011.
Endoscopic surgery using laser CO(2) was performed in 13 patients, using stapler in 6 patients and with open approach in 3 patients. Surgery time, oral intake and hospital stay were greater in the open approach (107 minutes, 8 days and 11 days respectively) and less in surgery with stapler (52 minutes, 3 days and 5 days) than the technique with laser (58 minutes, 5 days and 8 days). With the first intervention, 68% of our patients improved, a percentage that increased to 95% taking into account the second intervention in patients that relapsed after the first surgery. Complications appeared in 13.6% of the patients.
The treatment of choice nowadays for Zenker's diverticulum is endoscopic surgery. The endoscopic approach with stapler seems to present lower morbidity and a shorter hospital stay in comparison with the CO(2) laser.
多年来,针对Zenker憩室的手术治疗采用了不同技术,已从开放手术发展到内镜手术。内镜手术中可使用二氧化碳激光或吻合器。我们的目的是根据所施行的手术类型确定憩室的复发或持续情况。
对2001年至2011年间在我院接受Zenker憩室治疗的22例患者进行回顾性描述性研究。
13例患者采用二氧化碳激光进行内镜手术,6例患者使用吻合器,3例患者采用开放手术。开放手术的手术时间、经口进食时间和住院时间更长(分别为107分钟、8天和11天),使用吻合器手术的时间则短于激光手术(分别为52分钟、3天和5天,激光手术分别为58分钟、5天和8天)。首次干预后,68%的患者病情改善,若将首次手术后复发患者的二次干预考虑在内,这一比例增至95%。13.6%的患者出现并发症。
目前Zenker憩室的首选治疗方法是内镜手术。与二氧化碳激光相比,使用吻合器的内镜手术似乎发病率更低,住院时间更短。